【摘要】 目的探讨首次发作晚发抑郁(LOD)患者基线记忆功能与6个月神经认知结局的关系。方法选择LOD患者49例,随访6个月,根据认知评分标准,将33例患者分为认知正常组19例和认知障碍组14例。被试基线和随访6个月时,均接受简易智能状态检查量表、认知筛检测验及神经心理成套测验评估。采用3.0 T MRI仪行头颅扫描,液体衰减反转恢复序列采集图像,测量脑白质高密度信号体积;采用聚合酶链反应技术进行载脂蛋白E基因分型。结果与认知正常组比较,认知障碍组患者基线简易智能状态检查量表及认知筛检测验总分、言语记忆和视觉记忆各测验评分、言语流畅性(1 min)、视空间功能评分及定向力均明显降低,差异有统计学意义(P<0.05)。logistic回归分析显示,LOD患者基线物品即刻回忆评分与神经认知结局呈负相关。结论 LOD患者基线即刻回忆能力可预测其认知转归,基线时即刻记忆越差,神经认知恶化的风险越大。更多还原

【Abstract】 Objective To explore the potential predictors of neurocognitive outcome in elderly with first-episode late-onset depression(LOD).Methods Forty-nine LOD patients were recruited and followed-up for 6 months.Thirty-three with remission were classified into cognitively stable(n = 19) and cognitive impairment groups(n = 14).The subjects received MMSE,cognitive abilities screening instrument(CASI) and comprehensive neuropsychological battery test at baseline and 6 months.They were examined with a 3.0-T MRI system.FLAIR images were acquired for the volumetric measurement of white matter hyperintensity.PCR-RFLP technique was used for apoE genotyping.Results The baseline scores of MMSE and CASI in cognitive impairment group were significantly lower than cognitively stable group(P<0.05).Compared with cognitively stable group,the performance of tests of verbal memory,visual memory,verbal fluency and visuospatial function were significantly poorer in cognitive impairment group(P<0.05).Multivariate logistic regression analysis showed that the score of immediate object memory test was negatively correlated with cognitive decline in LOD patients(OR = 0.31,95%CI:0.13—0.70).Conclusion Baseline immediate memory can predict the neurocognitive outcome of LOD patients.Depressive elderly with worse immediate memory performance may be at greater risk of cognitive decline.更多还原